engleski

Comparison of regional and general anesthesia for major shoulder surgery, prospective study.

Background and purpose: Major shoulder surgery is often associated with severe postoperative pain. Our previous experience with local infiltration anesthesia and postoperative intravenous analgesia did not satisfy either patients or us. The interscalene brachial plexus block is ideal anesthetic and analgesic method for shoulder, clavicle and proximal upper extremity surgical procedures. Materials and methods: The study included consecutive patients scheduled for shoulder surgery (rotator cuff repair or shoulder arthroplasty) in the last 2 years. In the interscalene block group patients were sedated before application of the ultrasound guided interscalene block. After the block was performed, patients were anesthetized, relaxed and intubated and artificially ventilated. Light general anesthesia was maintained with inhalation anesthetic and muscle relaxant, and fentanyl added as needed. Patients who were operated in our institution before implementation of the method, those with a contraindication and those who refused blockade presented the control group. For them the general anesthesia was performed as usual. In both groups intraoperative and postoperative analgesic consumption, visual analog scale (VAS) at 6, 12 and 24 hours postoperatively, incidence of complications and patients' satisfaction was measured and recorded. Results: Both intraoperative and postoperative analgesic consumption and VAS scores were reduced and patients’ satisfaction increased in the interscalene block group. Success rate was 97%, and we noticed 1 minor complication that resolved spontaneously within 24 hours. Conclusion: Single shot interscalene brachial plexus block is a very efficient method of anesthesia and postoperative analgesia for painful procedures in the shoulder area.

shoulder surgery; anesthesia

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